Monday, March 22, 2010

The Guardian, part one

This is the first part of the story I've been writing for this semester's Fiction class. It's more or less a rough draft, because I ran out of time and wanted to add so much more to the story.
Part Two will be posted sometime around late April/early May, when the final draft is due. This has been so much fun to write - it'll be a struggle to finish it well, but we'll see what happens along the way.
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The sharp slam of his car door echoed across the quiet parking lot. Mark adjusted his tie and kept a firm grip on his clipboard as he made his way to the front entrance of Christ Hospital. There was an odd stillness in the air, except for the chirping from a few sparrows bathing in the puddles scattered around the hospital parking lot. The gray sky threatened more rain, but that was expected. Spring in Cincinnati was always rainy.

The automatic doors slid open with a hydraulic hiss. Mark took a deep breath as he approached the welcome desk. The girl behind the desk was watching him walk, and it made him uncomfortable. “Hi there.” Be professional, idiot. “ I’m Dr. Buckley, and I have an appointment with Dr. Fletcher.”

“Oh, okay.” The girl handed him a laminated clip-on Official Visitor badge, clumsily working around her long press-on nails. “She’s in Cardiology. Go down the hall and take the last door on the left.”

“Thank you.” Mark clipped on the badge and adjusted his tie again out of nervous habit. Keep it together. You’re halfway there.

The nurse’s station door in Cardiology was locked, and Mark had to show a passing nurse his visitor’s badge before she let him through. Inside, in the midst of all the nurses rushing busily around inside the station, was a forty-something redheaded woman in dress-suit and a lab coat, standing by the patient roster, checking over a hardbound chart while the chaos of the nurse’s station parted to avoid her.

Mark tried his best to look professional and impressive – his first consultation was definitely not going to be his last. “Hello there; I believe you’re expecting me.” He fumbled for his visitor’s badge. “I’m here to consult on a patient’s psych evaluation.”

“Dr. Buckley?” The woman closed the chart and took off her reading glasses. She looked at him, and paused for a moment too long. “You’re early. I’m Dr. Carrie Fletcher – welcome to chaos.”

“Thank you.” He risked a glance at the chart in her hands. The front label had already been filled out: Rita Hayes | Room 201 | Fletcher. “I’d like to get right to business, if you don’t mind. Is this the patient’s chart?” He knew it was – why else would she be holding it already?

“Yes, of course.” Dr. Fletcher seemed hesitant.

Mark looked at her over the rims of his glasses. “Is something wrong, Dr. Fletcher?”

“No, no,” she said hurriedly, which meant there was. “…it’s just that you’re… younger than I expected.”

He smiled. “I get that a lot.” He did. In his school days, becoming a psychiatrist years ahead of his peers used to be a thrilling idea. Since then, the practical world had replaced that thrill with embarrassment. “Gifted” was the term his mother liked to use; others preferred “too young.”

Since the first few sections of medical charts were always the boring legal documents and informed consent papers, Mark skipped immediately to the Assessments tab. He tried to read quickly as he followed Dr. Fletcher’s brisk pace. The chart said Rita was fifty-seven, that she lived alone, and that a heart attack had brought her to the hospital. The nurses reported that a search for her only remaining family, a seven-year-old son in Dayton, had ended with a death certificate dated sixteen years ago. On the chart, Dr. Fletcher had written (in typical almost legible doctor’s-scrawl) hurried notes like “Refuses to acknwlg son’s death – insists he is alive. Delusional? Call for psych eval.”

Mark managed to scan the last few pages of the chart before Dr. Fletcher opened the exam room door for him. Closing the chart hurriedly, he tried to smile as warmly as possible at his patient.

Rita Hayes did not look very old, but her age showed in the laugh-lines around her eyes. She also looked significantly less crazy, and more like a regular patient, than the chart made her sound, especially now that she was sitting idly in her sterile hospital bed and wearing her standard hospital gown. There were no bandages on her arms, no burns, no cuts; nothing at all like a textbook schizophrenic. Her eyes were watching him, not darting around distractedly or staring into space. She seemed as lucid as anyone else.

Mark moved to shake hands with the patient. “Hi, Rita, I’m Dr. Buckley. I’d like to talk with you for a few minutes, if you don’t mind.”

“I don’t mind at all.”

“All right, then.” Mark sat in the chair next to her bed and had to rummage in his pocket for his pen. How unprofessional. “…tell me, Rita, why are you in the hospital?”

“I had my first heart attack last night. I’m afraid this old body just isn’t what it used to be.” She chuckled.

Mark had to smile. “Well, that tends to happen after a while, you know.”

“Now, you’re too young to know anything about that!” Her voice was level and strong, and she was making eye contact whenever Mark paused his note-taking. And she was still smiling. Was she always this cheerful?

“Has anyone contacted your family, or is there someone else you’d like to call?”

Rita’s smile faded. “I tried to explain to the nurses about my son, Devin, but I have—met with some resistance about that.”

“I see.” Mark hesitated, and tried to choose his next words carefully. “When was the last time you spoke with your son?”

“Last Thursday. It’s not usually so long, but he had to go away for a while.” There was a pause. “Did Dr. Fletcher put you up to this?”

Uh-oh. He fought the urge to look to the other doctor for support –or a bail-out; whatever came first– and racked his brain for an answer. “Well, I…”

Luckily, Dr. Fletcher recovered faster than he could. “I asked Dr. Buckley to come in and ask you a few questions, but that’s all. If you want him to leave, you have the right to say so.”

Rita’s cheerfulness was gone; she was frowning at Dr. Fletcher now, and Mark tried not to look like he was watching. By the time she turned her attention back to him, her frown was more subdued. “I guess it wouldn’t be fair to shoot the messenger; it’s not your fault she dragged you into this.”

“All right,” he said softly, “but we don’t have to continue if you don’t want to.”

“No, I don’t mind.” Except that her furrowed brow said she did; just a little, perhaps, but just enough. “What else would you like to know?”

Mark checked his notes nervously; he had lost his place. “…well, ah—When Devin said he was going away, did he say where, or for how long?”

“No, he said he couldn’t tell me. Worries me to death when he does that – he has to keep little secrets, though. It makes him feel special, I think.”

“That must be difficult for you.”

Rita sighed through her nose. “Well, no, what’s ‘difficult’ is these doctors trying to tell me that I don’t know my son is dead. I never said he wasn’t!”

Mark’s eyebrows shot up. “You—you’re saying he is, then?”

“Well, yes and no – he died, Dr. Buckley, but he’s still with me.” She looked distracted now; she was smiling to herself. “He’s my little angel. My wonderful little boy is always watching over me.”

There was an uncomfortable pause, and Mark felt every moment of it. His mind was racing. He had studied delusions inside and out; he had written his exceedingly well-documented dissertation on this exact disorder; he had, according to experts in the professional world, become Cincinnati’s leading authority on schizophrenia. And now, in the wake of Rita’s perfectly lucid delusion, he had no idea what to say.

After what felt like an eternity, but was actually only a few moments of silence, his training kicked in. Keep her talking. Find out everything you can.

“He visits you often, then?”

“Oh, yes. He comes to see me at home all the time.” Her smile faded a bit, and she shifted uncomfortably in her bed. “If I’m not there when he comes,” she said softly, “he won’t know where I’ve gone.”

Mark gave her what he hoped was a kind (and not a pitying) smile. “I’m sure he’ll be all right for a while, but we’ll try to get you home as soon as possible.”

Dr. Fletcher closed her office door quietly behind her, and gestured for Mark to have a seat in the chair beside her desk. “That could’ve been worse,” she said, almost to herself.

“Well, that’s reassuring.” Mark took the opportunity to glance over his notes again, as scattered and semi-legible as they were. “How long do you plan to keep her here?”

“That depends on you, I’m afraid. If you give me the go-ahead, we can have her moved into a treatment program as early as tomorrow morning.”

“It’s a textbook delusion. Rita not only believes in a delusion, but she refuses to accept anything that challenges it. And the strength of the conviction in her voice, in her body language… it’s fascinating. It’s as if she created this fantasy to block out the grief and the reality of her loneliness.”

Dr. Fletcher’s chair squeaked as she shifted her weight forward. “Do you agree that she’s a candidate for institutional treatment?”

Mark looked up from his clipboard. She was watching him closely, her green eyes flitting around to spot each potential tell in his expression, even though he had tried so hard to maintain a stolid front. What is she looking for? Finally, he found his voice. “It’s difficult to say.”

The corners of Dr. Fletcher’s mouth eased into a smirk. “It’s difficult to say that we shouldn’t help a woman who can’t face the reality of her son’s death?”

“No, it’s not that.” Mark swiveled in the chair as he fell deeper into thought. “But something just doesn’t fit right,” he mused aloud. “If Rita truly was schizophrenic, other symptoms would have emerged by now – but she’s as lucid and communicative as I am.”

“The hospital is willing to do whatever it takes to help her–within reason–but I’m not equipped to treat a schizophrenic patient here. One of my colleagues at University Hospital could put her in psychiatric care.” She leaned back in her chair, looking at him over her steepled fingers. “It’s a good program, and they’ll take care of her. That’s what you’re worried about, isn’t it?”

It was, but he wasn’t about to say so; the state-sponsored mental institutions were as close to being comfortable prisons as their HR departments would allow. He knew a teaching hospital like University would be better than that, but only because anything would be. Still, helping a delusional woman lose her only comfort in life was not the way he thought he would start his career—but he was probably too young to have professional pride.

In any case, Dr. Fletcher wasn’t giving him much of a choice.

Mark took off his glasses and rubbed at the indentions they left on the bridge of his nose. “…all right, let’s do it. How soon can University start her treatment?”

-----

Mark was too tired to care about catching the front door, or about how loudly it slammed behind him – it was nice to finally be home. His apartment was dark, as always, and today it smelled more strongly of the cat than usual. He sighed to himself and tried to ignore the odor of urine. With all the fuss he had made about preparing for his first consultation, he had forgotten to change Sybil’s litter-pan this week. He had taken almost ten paces from the door before the black-and-white cat came out to circle around his feet, meowing in her quiet, chirping way and rubbing her loose hairs all over his clean black pants. When he picked her up and reached to pet her, she swatted at his hand and started biting his fingers – he had forgotten to feed her, too.

He carted the irritated Sybil over to her food and water bowls, cringing all the while at the sharp needle-like pain of her teeth sinking into his unprotected flesh. The sound of food pouring into her bowl provided enough distraction; she immediately stopped biting him and began to purr. Mark left her happily crunching on her dry cat food. He had escaped remotely unscathed this time.

After preparing his own dinner of fresh-from-the-freezer chicken, he sat down at his computer and pulled up an internet search for University Hospital. Their website looked innocent enough, like their system had been overhauled by a politically correct web-designer subcontracting to an expensive photographer. They even called their psychiatric unit “Behavioral Health Services”—it all seemed so cheery and helpful. Too cheery and ridiculously helpful.

Sybil jumped up on the desk and started batting at the chicken in his hand, and managed to scrape a claw across one of his fingers. “Hey! Wait ‘til I’m done, brat.” He tore off a piece of meat and tossed it over his shoulder. Sybil took a flying leap and chased it down, scrabbling to get a grip on the hardwood floor. He couldn’t help but chuckle at her. Spastic cat.

Mark brushed the breading-crumbs from his fingers before opening another search. He tried “Devin Hayes” in every public database he could think of, but found nothing. Finally, he unearthed an archived news article from a small-time newspaper with an even smaller website. Devin Hayes, a seven-year-old local boy, drowned a few miles from his home – and the paper called it a “tragic accident.” There were no witnesses or passers-by to save the boy when he fell into the river. The only family, his mother Rita, had refused to comment at the time.

There was a subsequent article of an attempted suicide two months later: Rita Hayes, age forty-one, ran a red light and wedged her car under an eighteen-wheeler’s back tires. Detailed pictures of the gnarled wreckage –what was left of Rita’s car– sent a shiver down Mark’s spine. Half the car had been flattened by the truck’s massive wheels, and the other half had been mangled and twisted beyond recognition, except for the area around the driver’s seat. The car insurance company had to identify the make and model based on their own records. Everyone interviewed by the paper said the same thing: Rita Hayes shouldn’t have survived.

Mark spent the rest of the evening trying to forget about Rita’s case. It was out of his hands now, and there was nothing else he could do; and yet, the images of the wrecked car still haunted him. A crash like that was nearly impossible to walk away from, but she did. She had seemed so happy and confident at the hospital - not at all like a grieving mother with a history of attempted suicide.

Finally, worn out from the long day, Mark went to bed. His apartment was colder than usual – he was shivering when he crawled under the covers. Sybil hopped onto the bed behind him and curled up behind his legs. He couldn’t shake the odd unsettled feeling deep in his gut at first, but eventually he was lulled to sleep by dull pattering of rain on his window and the soft rhythm of Sybil’s breathing.

It didn’t last long. Around three a.m., he leaped out of bed and ran to the bathroom, where he promptly vomited into the toilet. Several times. Shaky and weak, he pulled himself up to the sink and rinsed his mouth out. The godawful taste of acid and liquefied chicken made him feel sick all over again.

He spent the rest of the night on the bathroom floor with his dirty clothes as a pillow, only sleeping in fitful dozes. Every hour or so he would wake up and be sick again – how much could his stomach hold? Even when he thought nothing was left, something came up. It was a miserable night. His back and neck ached from lying on the hard floor, his sinuses burned with the stink of stomach acid, and his abdomen was sore from heaving endlessly into the wee hours of the morning.

As the stormy night gave way to a rainy dawn, exhaustion took over, and he slept.

-----

Cat claws scratching on the wooden door were loud enough to rouse Mark from his feverish slumber. He sat up, stretching out the stiffness in his back as he went, and let Sybil in the bathroom with him. She pawed at his knee to make him pet her and, when she grew tired of being adored, ran out – no doubt to sit hopefully next to her food bowl.

He groggily stumbled out and made it as far as the living room couch. It was already half past ten in the morning. Everything still hurt, and his throbbing head felt like it was stuck in a fishbowl, which could only mean his fever was getting worse.

After feeding his cat, he called in sick at his practice. His assistant would have to cancel all his appointments, but he didn’t care. Mark curled up on the couch with crackers and ginger ale, and prayed he could keep it all down. He slept most of the day, whenever he wasn’t running back to the bathroom; any solid food he tried to eat eventually came back up, and as the afternoon wore on, he found it harder and harder to swallow anything at all. This is ridiculous, he thought drearily. Whatever had decided to wage war against his immune system didn’t feel like bad food, a stomach virus, or even the flu – it felt much worse. It felt like poison.

He didn’t realize he had dozed off until something woke him: a soft whisper, barely a breath, from somewhere in the room. He thought it was Sybil at first, but she was asleep at his feet. It sounded like… Crying—? Someone’s crying? How—?

Mark sat up and looked around. The living room was empty.

The crying grew louder. He dazedly scrambled to his feet. “Hello?”

No answer.

He stumbled toward the kitchen in search of the source. It was already dark outside, and he hadn’t turned on any lights in his apartment. When he flipped the All On switch and flooded the apartment with light, the sound stopped. A young boy sat in a heap in the middle of the kitchen floor, his eyes bloodshot and his face red from crying. Mark couldn’t keep himself from staring.

“How did you get in here?” He asked. Had he been too deeply asleep to hear him come in?

“I can’t—I can’t find her,” the boy sniffled. “I can’t find Mommy.”

Something about this boy made Mark’s stomach churn again. He tried to ignore it. “Where do you live? Maybe I can help you find her.”

“No!” The boy screamed. “Get away from me!”

Another wave of fatigue and nausea hit Mark head-on; he fell to his knees, convulsing with dry heaves. When the little boy thrust out his hand, the heaves stopped. The hand went up, and so did Mark – he was yanked up from his knees by an unseen force. Dangling a foot off from the floor, he writhed and struggled to break free from the invisible grasp.

The boy’s arm was visibly shaking with rage as he stood. His little fingers closed slowly into a fist. Mark felt his airway closing. He panicked, thrashing around in midair, scratching his own neck as he clawed at restraints that weren’t there. His screams were strangled in his throat before they could even come out.

“You’re a bad man,” the little boy growled. “You sent her away. I won’t let anyone take Mommy away from me!”